Dr. Paul Donohue Good Health

DR. PAUL DONOHUE GOOD HEALTH

June 18, 2003|DR. PAUL DONOHUE GOOD HEALTH

Dear Dr. Donohue: I am 25. Ever since I began to have menstrual periods, they have been quite heavy. A hematologist determined I have von Willebrand's disease. I am now on birth control pills but will be given a nasal spray if my periods do not normalize. What spray? -- S.J.

Dear S.J.: Von Willebrand's disease is the most common bleeding disorder. It's inherited. I bet that if you track down aunts and cousins, you'll find others who have heavy menstrual periods.

Blood contains a number of proteins called clotting factors. Along with blood platelets, clotting factors seal with a clot any breach in a blood vessel. The von Willebrand factor is one of the clotting proteins. Without it, brisk bleeding can occur from minor mishaps, such as a bleeding nose. For women, excessive menstrual bleeding is a major clue.

By regulating menstrual periods, birth control pills can often put a stop to heavy menstrual bleeding.

The spray you refer to is desmopressin, DDAVP. It raises blood levels of von Willebrand factor by flushing it out of body storage sites. In severe bleeding, injections of the factor are necessary.

You must tell every doctor you see that you have this problem. In particular, you must let your doctors know about it if you are scheduled to have surgery.

Dear Dr. Donohue: I have a Bible bump on the back of my wrist. It's supposed to disappear if you hit it with a Bible. Done that. No result. What's next? -- J.W.

Dear J.W.: The lump you call a Bible bump is a ganglion. Ganglions are cystic structures that arise from joints or tendons, and the wrist is the most common spot to find one.

They can arise for no reason, or they can blossom due to repeated stress on the joints or tendons. Gymnasts, for example, are prone to having ganglions because they fly from one bar to another and catch themselves with their hands. Their wrists take a beating.

If a ganglion doesn't hurt or doesn't interfere with joint function, it can be left alone. If it causes trouble, doctors can draw off the gelatinous material within the ganglion with a needle and syringe. Then, they can inject cortisone to prevent it from reforming.

Surgery is the ultimate cure. Even with surgery, however, a ganglion can come back.